CMS Price Transparency Data

MRI, knee or other leg joint

Facility: UPMC Children's Hospital of Pittsburgh

Billing Code: 73721 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 73721
  • Insurance Median: $1,946
  • Cash Discount Price: $2,125
  • vs. Medicare Baseline: 7.98x Medicare
The contracted insurance negotiated median rate for a MRI, knee or other leg joint at UPMC Children's Hospital of Pittsburgh is $1,946. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,125. Compared to the federal Medicare reimbursement reference rate of $243.77, this hospital’s rate is 7.98x the Medicare baseline. Located in One Children's Hospital Drive, Pittsburgh, PA.
Cash / Self-Pay
$2,125

Average discount available for prompt cash payment at this facility.

Insurance Median
$1,946

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$243.77

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $243.77 (100%)
Cash / Self-Pay: $2,125 (872%)
Insurance Median: $1,946 (798%)
Cash: $2,125 (872% of Medicare)
Ins. Median: $1,946 (798% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $243.77 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 798% of the Medicare baseline (a markup of 698%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $229 - $1,948 94%
Health Plan Of Upper Ohio Valley $230 - $2,302 94%
Blue Cross Blue Shield $245 - $2,287 101%
Amerihealth Caritas $249 102%
Cigna $249 - $1,948 102%
UnitedHealthcare $1,068 - $1,664 438%
Geisinger $1,592 - $1,948 653%
Upmc Health Plan $1,680 - $2,085 689%
Intergroup $2,302 - $3,010 944%
Coventry/First Health $2,833 1162%
Saudi Armed Forces $2,833 1162%
Health Payors Organization $3,010 1235%
Multiplan $3,010 1235%
National Provider Network $3,187 1307%
Private Health Care Systems $3,187 1307%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Children's Hospital Drive, Pittsburgh, PA 15224
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Childrens